OBJECTIVE: Lithium inhibits the action of inositol monophosphatase(IMPase) in phosphoinositide(PI) signal transduction system at therapeutically relevant concentration. The depletion of inositol by lithium itself cannt explain the lithium's therapeutic effect. However, attention has focused on the abnormality of PI signal transduction system as the pathophysiology of bipolar affective disorder(BPD). We investigated whether IMPase mRNA levels of lymphocytes would be different between BPD patients(n=16) and age, sex-matched normal controls(n=16). We also investigated the change of IMPase mRNA level by lithium during 4 weeks to probe the possibility that IMPase mRNA levels could predict the therapeutic response to lithium and clinical course. METHOD: Relative IMPase mRNA levels in lymphocyte were quantified by reverse transcriptase(RT)-PCR in sixteen drug-free BPD patients and sex, age-matched normal controls. The psychopathology of patients were measured using YMRS(Young Mania Rating Scale) and CGI(Clinical Global Impression). RESULTS: There was no significant difference in IMPase mRNA levels between BPD patients and normal controls. And the IMPase mRNA levels were not significantly changed by 4 week treatment with lithium. However, the basal IMPase mRNA levels were negatively correlated with the changes of CGI after 4 weeks. Furthermore, the patients with relatively high basal IMPase mRNA levels showed much more improvement during 4 weeks. CONCLUSIONS: BPD patients and normal controls were not distinguished by lymphocyte IMPase mRNA level. Although we do not support the hypothesis that lymphocyte IMPase activity would be related with the pathogenesis of BPD and the action of lithium, these data raise the possibility that lymphocyte IMPase mRNA levels could function as a predictor of therapeutic response and clinical course of BPD.
5'-Nucleotidase ; Bipolar Disorder ; Humans ; Inositol* ; Lithium* ; Lymphocytes* ; Mood Disorders* ; Psychopathology ; RNA, Messenger* ; Signal Transduction

BACKGROUND: It has been well known that absolute and interpeak latencies of brainstem auditory evoked potentials (BAEP) are usually prolonged in diabetics. However, Its etiology is still controversial. We tried to identify whether the cause is structural or metabolic in origin by performing BAEP and brain MRI in the diabetic patients. METHODS: BAEP were performed in both the diabetic patients (DM) group (16 males and 15 females) and the normal control group (25 males and 33 female). A brain MRI was performed in the DM group on those who showed abnormal BAEP and com-pared the results of BAEP of the DM group with those of the control group. RESULTS: 7 patients (22.6%) showed abnor-mal BAEP (male; 6, female; 1, unilateral; 4, bilateral; 3) when abnormal BAEP was defined as being larger than two and a half standard deviations of the control group BAEP results. Two males of the DM group who showed abnormal structural lesions of the pons in their brain MRI were not included in the statistical analysis. The remaining 14 diabetic male patients (mean age: 58.7 +/-9.1 years, mean disease duration: 6.1 +/-4.7 years, mean hemoglobin (Hb) A1C: 7.7 +/- 2.0%) and 15 diabetic female patients (mean age: 60.6 +/-10.8 years, mean disease duration: 5.4 +/-5.1 years, mean HgA1C: 7.8 +/-2.1%) were stastistically analyzed. Interpeak latencies of I-III, III-V, and I-V were found to be signifi-cantly prolonged in the DM group. The prolongation of interpeak latencies of I-III and I-V were found to be signifi-cantly correlated with the disease duration only in the diabetic female patients, but not with age and HbA1c. CONCLUSIONS: These findings suggest that both metabolic derangement and structural lesion contribute to prolonging the central conduction time on BAEP pathway in diabetics.
Brain ; Brain Stem* ; Diabetes Mellitus ; Evoked Potentials, Auditory, Brain Stem* ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Pons

BACKGROUND: Onset of rocuronium is rapid but relatively large doses are needed to achieve a suitable intubating condition. So we compared the single bolus injection with divided injection of rocuronium about tlie onset time, intubation time and intubating condition. METHOD: Thirty patients were divided into three groups of 10 each randomly. Patients in group I were given a single dose of 0.6mg/kg rocuronium. Those in group 2I or 3 received 0.06 mg/kg or 0.09 mg/kg as priming dose followed by 0.54 mg/kg and 0.81 mg/kg as intubating dose 3 min. later. The train of four responses of adductor pollicis muscle was recorded using Paragraph(Utah Medical Product Inc. Midvale Utah, U.S.A.) every 10 seconds. The trachea was intubated by one clinician who was blinded to the muscle relaxant administered when he thought the patients were suitable for intubation, and he recorded the intubating conditions. The endotracheal intubation time and twitch height at the moment was recorded by other clinician. The onset time was recorded when the post tetanic count is marked as '0'. RESULT: The onset time of group 1, 2, and 3 were 90.0+/-22.lsec, 109.0+/-35.0 sec and 85.0+/-35.0 sec. respectively. Endotracheal intubation times were 77.0+/-10.6sec, 60.0+/-10.0sec and 44.0+/-5.2sec respectively. CONCLUSION: There was no differences about onset time between single and devided injection with same total dose or incremental dose of 0.9mg/kg. But the intubation time was faster in priming group with dose dependent manner, and the intubating conditions were excellent to good in all patients.
Humans ; Intubation* ; Intubation, Intratracheal ; Trachea ; Utah

This article was withdrawn by the authors' request.

Operations on the inner aspect of the pelvis are often necessary for irreducible fracture of the ilium, irreducible fracture of superior and medial portion of the acetabulum, tumors and infections involving iliac fossa, and fracture-dislocation and infection of the sacro-iliac joint. Until now Letournel and Judet's ilioinguinal and iliofemoral approaches provided access to anterior column of the pelvis by elevating muscle layer on inner aspect of the pelvis. We used modified iliofemoral approach using ASIS(anterior superior iliac spine) osteotomy to gain better access to anterior column, the pelvlc brim, and in some occasions as far as anterior sacroiliac joint while avoiding injury to the structures in the inguinal ligament and lateral femoral cutaneous nerve and reported six cases treated with this approach. In conclusion, a modified iliofemoral approach using ASIS osteotomy is a useful approach which can obtain an excellent exposure in the inner pelvis.
Acetabulum ; Ilium ; Joints ; Ligaments ; Osteotomy ; Pelvis ; Sacroiliac Joint

This article was withdrawn by the authors' request.

Purpose: The goal of this study was to evaluate the efficacy of suction drains following total hip arthroplasties, by comparing the post-operative results between the group with suction drains and the group without suction drains. Materials and Methods: Eighty-six patients, who underwent primary total hip arthroplasties from June 2001 to June 2004, were divided into two groups: group 1 (48 patients), with suction drains; and group 2 (38 patients), without suction drains. We assessed the perioperative hemoglobin and platelet levels, the amount of total blood loss, the amount of post-operative blood transfusions, post-operative ranges of motion (ROMs, at 6 weeks), wound problems, and general conditions. Results: Although the postoperative hemoglobin level was greater in group 2 than in group 1, there was no statistically significant difference. The amount of total blood loss and blood transfusions in group 1 were statistically greater than in group 2 (p<0.05). There were no statistically significant differences in the post-operative ROMs and wound complications between groups 1 and 2. Conclusion: There were no limitations of hip motion and no wound complications in the patients without suction drains after total hip arthroplasties. However, they required fewer post-operative blood transfusions than did the patients with suction drains, due to less post-operative blood loss; and the absence of a suction drain might prevent retrograde tube infections. In addition, patients without suction drains after total hip arthroplasties seemed to recover better did than those with suction drains. Therefore, suction drains might provide no benefit in total hip arthroplasties.
Arthroplasty ; Arthroplasty, Replacement, Hip* ; Blood Platelets ; Blood Transfusion ; Hip ; Humans ; Suction* ; Wounds and Injuries

The prevalence of gastroesophageal reflux disease (GERD) is increasing in Korea, and physicians, including surgeons, have been focusing on its treatment. Indeed, in Korea, medical treatment using a proton pump inhibitor is the mainstream treatment for GERD, while awareness of surgical treatment is limited. Accordingly, to promote the understanding of surgical treatment for GERD, the Korean Anti-Reflux Surgery Study Group published the Evidence-Based Practice Guideline for the Surgical Treatment of GERD. The guideline consists of 2 sections: fundamental information such as the definition, symptoms, and diagnostic tools of GERD and a recommendation statement about its surgical treatment. The recommendations presented 5 debates regarding fundoplication: 1) comparison of the effectiveness of medical and surgical treatments, 2) effectiveness of surgical treatment in cases of refractory GERD, 3) effectiveness of surgical treatment of extraesophageal symptoms, 4) comparison of effectiveness between total and partial fundoplication, and 5) effectiveness of fundoplication in cases of hiatal hernia. The present guideline is the first to demonstrate the efficacy of the surgical treatment GERD in Korea.
Evidence-Based Practice* ; Fundoplication ; Gastroesophageal Reflux* ; Hernia, Hiatal ; Korea ; Prevalence ; Proton Pumps ; Surgeons

Stature and four cephalometric measurements (head lengh, head breadth, bizygomatic diameter, bigonial diameter) were examined from samples of 461 Uygur in Xinjiang, China. Comparisons of head and facial morphology with geographically adjacent tribes were carried out to characterize Uygur population and to understand racial hybridity. Most of Uygur were hyperbrachycephalic as expressed by cephalic index and had larger lateral facial and smaller antero-posterior dimensions than Western Caucasians. The values of metric traits showed differences between East and West among Uygur populations. The results support the genetic diversity that seems to be caused by genetic hybridity and unequal growth between East and West in Uygur.
China* ; Genetic Variation ; Head* ; Humans ; Population Groups

OBJECTIVES: Many studies showed that risperidone and olanzapine in the treatment of delirium were similar to haloperidol, in side effects were superior to that. Quetiapine is frequently used in delirious patients. However, the studies of quetiapine in the treatment of delirium are very few. This study was designed to compare the efficacy of risperidone and quetiapine in elderly patients with delirium. METHODS: We divided 2 groups (risperidone and quetiapine) of elderly patients with delirium. We compared the two groups of elderly patients with delirium by Korean Version of Delirium Rating Scale (K-DRS) and Korean Mini-Mental State Examination (K-MMSE) at baseline and 1 week later. RESULTS: Our results showed that risperidone and quetiapine were efficacious in the treatment of elderly patients with delirium according to using K-DRS and K-MMSE. There were no significant differences in the degree of effects in both drugs. CONCLUSION: We compared the efficacy of risperidone and quetiapine in the treatment of delirium. Quetiapine was as efficacious as risperidone in the treatment of the elderly patients with delirium. In future, the sample size need to be increased in the studies of delirium. And the evaluation of long-term side effects related to quetiapine need to be performed.
Aged* ; Delirium* ; Haloperidol ; Humans ; Risperidone* ; Sample Size ; Quetiapine Fumarate